Performance Measures

Performance measures drive improvement in the quality and efficiency of health care service delivery to improve patient outcomes.

Women’s preventive health services need performance measurement to aid in the prevention and early detection of disease and to help women live healthier lives. Since the passing of the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, performance measures have become an essential component in the continued movement towards value-based payment, linking reimbursement for care delivery to the quality of the care provided. They are one of the mechanisms used to assess the quality of care patients receive and incentivize clinical care improvements. In addition to influencing payment, measures also provide transparency to the health care system through public reporting.

Performance measures are developed by various entities, including payers, credentialing bodies, and medical specialty societies. They examine many aspects of the health care system, including processes, outcomes, systems of care delivery, and patient perceptions.

WPSI Approved Recommendations

On this page, existing measures that align with the approved and HRSA-supported Women’s Preventive Services Initiative (WPSI) recommendations are highlighted. The measures listed on this page are intended to be a resource. They do not constitute an endorsement by the WPSI Advisory Panel or committee members, nor are they intended to be an exhaustive list of available measures.

Performance measures aligned with the WPSI recommendations

The following performance measures align with the approved and HRSA-supported WPSI recommendations. They have been developed by a variety of entities such as the National Quality Forum (NQF), Quality Payment Program (QPP), and HRSA’s National Performance Measures (NPM). These measures are utilized to assess quality in many federal and non-federal programs.

Breast Cancer Screening for Average-Risk Women

NQF 2372: Breast Cancer Screening

Breastfeeding Services and Supplies

NQF 0480: PC-05 Exclusive Breast Milk Feeding
QPP 336: Maternity Care – Post-Partum Follow-Up and Care Coordination
NPM 4: Breastfeeding

Contraception

NQF 2904: Contraceptive Care-Access to Long-Acting Reversible Contraception
NQF 2903: Contraceptive Care-Most & Moderately Effective Methods
NQF 2902: Contraceptive Care – Postpartum

Counseling for Sexually Transmitted Infections

NQF 0033: Chlamydia Screening in Women
NQF 0409 HIV/AIDS: Sexually Transmitted Diseases-Screening for Chlamydia, Gonorrhea, and Syphilis
NQF 1395: Chlamydia Screening and Follow-Up
NQF 0010: Young Adult Health Care Survey

Screening for Anxiety

Screening for Cervical Cancer

NQF 0032: Cervical Cancer Screening
QPP 309: Cervical Cancer Screening
QPP 443: Non-Recommended Cervical Cancer Screening in Adolescent Females

Screening for Gestational Diabetes Mellitus

QPP 443: Non-Recommended Cervical Cancer Screening in Adolescent Females

Screening for Diabetes Mellitus after Pregnancy

QPP 336: Maternity Care – Post-Partum Follow-Up and Care Coordination

Screening for Interpersonal and Domestic Violence

Screening for HIV

QPP 349: HIV Screening
NQF 0010: Young Adult Health Care Survey

Screening for Urinary Incontinence

NQF 0098: Urinary Incontinence: Assessment, Characterization, and Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older*

Well-Woman Preventive Visit

NPM 1: Well-Woman Visit
NPM 10: Adolescent Well-Visit

*Endorsement status has changed: Endorsement Removed

Adult and Child Health Care Quality Measures

The Centers for Medicare & Medicaid Services (CMS) publishes a core set of adult and children’s health care measures for those enrolled in the Children’s Health Insurance Program (CHIP) and Medicaid1,2. Measured voluntarily at the state level, these measures are intended to estimate the overall national quality of care and health outcomes for the beneficiaries of the program1,3,5. Quality measures can help support performance improvement and strengthen accountability to improve the quality of care provided across the country4. The quality measures included in each core set are reviewed yearly to identify gaps and strengthen the set. For more information on the annual core set review and selection process, please see the annual review and selection process HERE2.

The following quality measures, within each core set, align with the approved and HRSA-supported WPSI recommendations:

2022 Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set)

2022 Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core set)

2022 Core Set of Maternal and Perinatal Health Measures for Medicaid and CHIP (Maternity Core Set)

Additional Resources:

Reference:

  1. CMCS Informational Bulletin, November 19, 2020 – 2021 Updates to the Child and Adult Core Health Care Quality Measurement Sets (medicaid.gov)
  2. Medicaid and CHIP Child and Adult Core Sets Annual Review and Selection Process – DEPARTMENT OF HEALTH & HUMAN SERVICES (medicaid.gov)
  3. Adult and Child Health Care Quality Measures – Adult and Child Health Care Quality Measures | Medicaid
  4. Quality of Care Performance Measurement – Quality of Care Performance Measurement | Medicaid
  5. Fact Sheet: Quality of Care for Children and Adults in Medicaid and CHIP: Overview of Findings from the 2020 Child and Adult Core Sets – Overview of Child and Adult Core Set Reporting for FFY 2020 (medicaid.gov)

*NQF no longer endorses this measure

Well-Woman Chart

WPSI Coding Guide

Patient Education

Social Media Tool Kit

Recommendation Videos